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Search › Colorado › Medical Physician Assistant

Nancy Waller, PA

NPI 1093982647 · on the registry since 2008 · sole proprietor

Practice

Address
1339 S Pueblo Blvd
Pueblo, CO 81005
Phone
(719) 647-5831
Fax
(719) 647-5833
Organisation at this address
Boone Guest Home
Destiny Incorporated
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
Medical Physician Assistant
363AM0700X
Licence states on file
CO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2008-05-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado